Smoking in severe asthma

Abstract

Background: About one third of asthmatics have a history of cigarette smoking. Little is known about smoking in patients with severe asthma. The aim of this study was to assess the frequency of cigarette smoking and its effect on pulmonary function and asthma control in patients with severe asthma. Methods: We examined 103 outpatients (25% male, aged 22-82 yr, mean age 55.7 yr) with severe asthma according to ERS/ATS definition (2014) referred to our secondary care center by GPs. Their BMI varied from 18.4 to 52.2 kg/m2 (mean 27.9). Pulmonary function tests were measured by dry spirometer (2120, Vitalograph Ltd., UK). FeNO was measured by using a chemiluminescence analyzer (4000, Logan Research, UK). Asthma control was assessed by ACQ-5. Patients were treated according to GINA 4-5 steps. Results: Fifty nine percent of severe asthmatics had a history of smoking (45% were current and 14% - ex-smokers). Concomitant COPD was diagnosed in 41%. There was no difference between BMI in non-smokers and smokers (27.9 vs 28.0, p>0.05). Mean FEV 1 in non-smokers was higher (52.6% pred.) than in those who smoked anytime (46.9%, p 1 /FVC in asthmatics with smoking history was lower than in nonsmokers (0.56 vs 0.66, p Conclusion: Smoking is common in patients with severe asthma and is associated with lower pulmonary function and worse asthma control.